AIM: Vitamin D plays an important role in the pathological process of chronic liver disease (CLD), and the degree of vitamin D deficiency is related to the severity of CLD. The aim of our study was to investigate the association between severe vitamin D deficiency and the risk of all-cause mortality in patients with liver cirrhosis (LC). METHODS: The PubMed, Embase, and Cochrane Library databases were searched systematically for eligible studies from the earliest available date to 15 January 2019. The exposure and outcome of interest was serum vitamin D levels and all-cause mortality, respectively. The pooled risk ratio (RR) values and their 95% confidence intervals (CIs) were calculated through a meta-analysis. RESULTS: Eight studies published from March 2013 to January 2019 were included, involving 1,339 patients with LC. The meta-analysis showed that a severe serum vitamin D deficiency was associated with an increased risk of mortality in patients with LC (RR = 1.79; 95% CI 1.44-2.22; P < 0.01). CONCLUSION: Our meta-analysis confirmed the association between severe vitamin D deficiency and mortality risk, suggested serum vitamin D level as a new index to predict the prognosis, and emphasized the importance of vitamin D supplementation in LC patients.